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Safety of once-weekly glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes

Dhiren Patel

Published 2018 in Journal of the American Association of Nurse Practitioners

ABSTRACT

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been shown to be efficacious in lowering HbA1c in patients with type 2 diabetes (T2D) and are associated with reduction in meal-related hyperglycemia and bodyweight, low rates of hypoglycemia, and most recently, with reduction of major adverse cardiovascular events for all of them. This narrative review compares the safety of the existing once-weekly (OW) GLP-1RAs with other currently available antidiabetic treatments. Key safety data from 29 sponsor-led trials of albiglutide, dulaglutide, exenatide extended-release (ER), and semaglutide were included in the analysis. Once-weekly GLP-1RAs were associated with lower rates of hypoglycemic events compared with most other antidiabetic agents. Gastrointestinal adverse events were common, tended to dissipate with time, and tended to be less frequent with albiglutide and exenatide ER compared with semaglutide. Of the currently approved OW GLP-1RAs as of Q4 2018, exenatide ER is the only one without an indication for patients with T2D with comorbid severe renal impairment or end-stage renal disease. Implications for practice: OW GLP-1RAs offer a well-tolerated therapeutic option for T2D. Further studies are needed to further differentiate the safety profiles of OW GLP-1RAs.

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